Abstract
Heart failure affects millions of Americans and new diagnosis rates are expected to almost triple over the next 30 years as our population ages. Affective disorders including clinical depression and anxiety are common in patients with congestive heart failure. Furthermore, the presence of these disorders significantly impacts quality of life, medical outcomes, and healthcare service utilization. In recent years, the literature has attempted to describe potential pathophysiologic mechanisms relating affective disorders and psychosocial stress to heart failure. Several potential mechanisms have been proposed including autonomic nervous system dysfunction, inflammation, cardiac arrhythmias, and altered platelet function. These mechanisms are reviewed in this article. Additional novel mechanisms such as mental stress-induced myocardial ischemia are also discussed.
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References
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Acknowledgments
This study was supported by grants HL 070265 and HL 072059 of the National Heart Lung and Blood Institute. This material is also the result of work supported with resources and the use of facilities at the Department of Veterans Affairs Medical Center, Gainesville, FL.
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York, K.M., Hassan, M. & Sheps, D.S. Psychobiology of depression/distress in congestive heart failure. Heart Fail Rev 14, 35–50 (2009). https://doi.org/10.1007/s10741-008-9091-0
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DOI: https://doi.org/10.1007/s10741-008-9091-0